Scope of Practice
Scope of Practice Statute:
Please see sections of RSA 326-B, Nursing Practice Act.
- Section: 326-B:14 Scope of Practice; Licensed Nursing Assistant.
- Section: 326-B:13 Scope of Practice; Licensed Practical Nurse.
- Section: 326-B:12 Scope of Practice; Registered Nurse.
- Section: 326-B:11 Scope of Practice and Authority; Advanced Practice Registered Nurse.
Scope of Practice Advisories and Position Statements
Position Statements and Advisories from the New Hampshire Board of Nursing
It is the expectation of the New Hampshire Board of Nursing that registered nurses working in specialties are familiar with the New Hampshire Nurse Practice Act, Rules and Regulations, policies of their respective facilities, and specialty-specific standards of practice. Activities performed under a nursing license must also comply with workplace policies. A workplace may prohibit a licensee from performing tasks that are allowed by the provisions of the Nurse Practice Act and Rules, but may not require a licensee to do more than the Practice Act and Rules allow.
Health care is constantly changing, and thus the practice of nurses and nursing assistants is changing. It would be impossible to develop a list of all procedures and interventions that are included in the scope of practice of nurses. Licensees are encouraged to utilize the Decision Tree algorithm in determining scope of practice for activities not included in these lists. If scope of practice remains unclear following use of the algorithm, licensees may submit a question to the board using the Clinical Practice Inquiry Process and Form. The board office also suggests licensees seek legal counsel for clarification of their particular scope of practice based on license, education and continuing competence.
Licensees should be mindful of the professional responsibility to maintain competency as specified in NUR 404.12, which states, "All licensees shall, through education and experience, maintain the ability to competently practice nursing or nursing related activities."
When adding nursing interventions and nursing related activities to role responsibilities, in addition to those interventions taught during the initial educational process, it is the recommendation of the Board that facilities consider implementation using the following guidelines as applicable:
- Describe the educational preparation and practice history of the nurses or nursing assistants authorized to perform the intervention(s) or activity(s)
- Define the intervention(s) or activity(s) and the procedures for implementing the intervention(s) or activity(s)
- Include a written plan for attaining and maintaining competency of the licensee
- Identify the names of those nurses or nursing assistants authorized to perform the interventions or activity(s), and
- Be reviewed and updated as needed, but at least yearly
The following links contain responses to specific frequently asked questions pertaining to RN, LPN and LNA scope of practice.
- Advanced Airways, Insertion of, Role of the RN
- ANA Decision Tree for RN Delegation
- Anesthesia, Sedation, and Analgesia, Role of the RN and LPN in the Administration of
- Complementary and Alternative Therapy, Role of the RN
- Camp Nursing
- Clinical Practice Inquiry
- Compounding Definition
- Delegation and Supervision
- Delegation of Rescue Medications
- Delegation to Medical Assistants
- Dermatology/Cosmetic Services, Role of the RN and LPN
- Diagnostic Imaging, Role of RN
- Educational Advisory on Delegation to an LNA in the Community Setting (HB484)
- Endoscopic Procedures, Role of the RN
- First Assistant (RNFA), Role of RN
- Glucagon Administration by Unlicensed Personnel in the School Setting
- Home Health Nurses and Medications
- IV Therapy, Role of the RN
- Medication-Related Processes
- Medical Marijuana Position Statement and FAQs
- Nail Care
- Needle Decompression for Tension Pneumothorax, Role of the RN
- Nurse Driven Protocol Position Statement
- Nurse Delegation and the LNA HB 484
- Off-Label Medication Use, Role of the RN
- Palliative Sedation
- School Nurse Delegation Standards
- School Nursing, Role of the RN, LPN and LNA
- Simulation Guideline
- Telehealth, Role of the RN and LPN
- Women's Health, Role of the RN
- Homecare LNAs deliver an oral medication in emergency query
The Board of Nursing also recommends that licensees consult with appropriate regulatory/licensing boards to answer questions about specific procedures and/or practices that may be regulated by an entity other than the Board of Nursing, including but not limited to:
- Board of Medicine (licenses and regulates physicians, including allopathic and osteopathic, and physician assistants)
- Board of Mental Health Practice
- Board of Pharmacy
- Board of Acupuncture Licensing
- Board of Massage Practitioners
- Board of Dental Examiners